Any Canadians get insurance help?

[Amberbo 7]

Hi everyone, I am from Alberta, Canada and I am thinking about getting surgery done in Mexico. Is there anyone on here from Alberta who had inquired and received coverage for their surgery? If so what did you do, who did you go thru and did you have to have the procedure done in Canada in order for it to be covered? All the info you can give would be awesome!

[fat_free 463]

Hi there I had surgery through AHS here in Alberta so it was 100% covered. However, i have heard of others that have gone to Mexico and then submitted their backup to AHS and had some of the costs (around 50% I think) covered. If you search VSG claim to Alberta health you could probably find the info on how to do this.

[Chanti_ 27]

I have never heard of any provincial health insurance covering a surgery outside of Canada. I know that here in Nova Scotia, if for example your child needed cardiac surgery @ Sick Kids in Toronto that would be covered because the surgical expertise is not available here. But as there is a bariatric surgeon here (1, with a 10 year wait list) there is no coverage to travel for this type of surgery. I had my VSG in Mexico, I was self pay but it was worth every penny.

[fat_free 463]

Kelly- Anne H whom I have met, was able to get her surgery partially reimbursed as well as her husbands, daughters and even her sister had the surgery in Mexico. Kelly-Anne is in Edmonton

See her post below on obesity help

http://www.obesityhelp.com/forums/AB/4602926/Alberta-Health-Insurance-Plan-paid-for-part-of-my-Mexico-DS/

[Amberbo 7]

I read that post and I noticed the date and I think the ahc rules have changed since then but I will be doing some research to see if I can put in some sort of claim to help with the financial dent this procedure will do to my bank account if I do it.

[Amberbo 7]

@chanti...I have read on some posts that there is a bariatric surgeon in red deer but the waiting list is very long and the cost is like double or something like that then Tijuana so and somewhere I read that the procedure in Toronto is like 22,000. :/

[fat_free 463]

Kelly -Anne's husband and daughter had the surgery in June or July of 2014

[Amberbo 7]

Oh did they? I thought it said 2012...maybe it was another post...I have been reading so many in the last 2 days lol but I will definitely check into ahc that's for sure

Edited January 13, 2016 by Amberbo

[Xena7158 26]

I'm in Alberta as well - and I did quite a bit of research on this! I found many sleevers who went to Mexico to get the surgery (as recently as last year - 2015) and were able to apply to Alberta Health Care for a refund (partial), and then claim the rest on that year's taxes as medical expense (line 330, I believe) and got back a bit of money that way as a result as well.

For the Alberta Health Care - if you go to their website, there is a link to download the form for Out-of-Country Medical Claim Form (http://www.health.alberta.ca/AHCIP/submitting-claims.html). However, the link for that form (and that form only!) is broken ... but the error message says, if you want one of these, you can email and ask them for one and they will send it to you in the post (but not by email). I did this, and I got one! It took about 2 weeks from the time I asked for one and when I got it.

The folks who did this with AHC said they paid between $5000 and $8000 CAD for their surgeries, and the amounts they got back was between $1300 and $1735.

The one guy said he got about $1400 back from AHC, and then when he put the rest on his taxes, he ended up getting another $2000 back from his taxes.

**Keep in mind that the this is a credit, not a tax deduction - and there are minimums to claim before they will apply it - I only mention this because who knows what else that guy claimed as medical expenses that year along with his surgery - the more he claimed, the more he would get back - and only if you paid enough taxes in the year in order to reduce them by your % of medical claims from** so, it is hard to estimate what kind of return you'd get without knowing more income details, etc.

I talked to my GP about this - and he said he didn't know about claiming on AHC - but he had patients who had claimed out of country stuff on their taxes - and then got 'questioned' by the CRA about the expenses. They were asked to prove that the expense was medically required. My doc said he would write a letter stating my medical requirement and long wait times etc - he's done it for other patients, and they got their refund after they provided it to CRA.

Oh, and another note about claiming on AHC - when you get the form to request the refund, they list a few things they want you to provide:

(1) surgical/operative report,

Bills showing:

(2) itemized statements of practitioner's services, and

(3) itemized hospital charges on official statement/letterhead - all of which must be in English,

AND a

(4) receipt of payment.

When I looked into these itemized statements required - I did find a few folks in various forums - who said they had trouble getting itemized bills from their surgeons in Mexico (I'm not going to name them), ie still waiting for a response, given 6-8 week waiting times, only got partial statements, only got statements in Spanish (and had to subsequently pay more to get them translated), and one in particular who flat out refused to send them the itemized bills and would only provide the amount paid and receipt. That person said they were declined the refund by AHC.

So if you are hedging your bets on getting a subsidy afterwards, I'd probably make that one of the questions you ask your prospective surgeons - if they will provide the items you need to at least apply for the refund!

Edit - forgot to mention that the folks who posted, said that the refund from AHC took about 3 months to get

Edited January 14, 2016 by Xena7158

[Amberbo 7]

Thanx xena7158, I will check that out for sure!